Forbes: Medicare should stop paying for chiro and OMT

[drusso]

Medicare Data Reveal $564 Million Wasted On Chiropractors And Osteopathic Manipulation

Is this accurate? How should Steven Salzberg be held accountable for his views and opinions?

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[lobelsteve]

Medicare Data Reveal $564 Million Wasted On Chiropractors And Osteopathic Manipulation

Is this accurate? How should Steven Salzberg be held accountable for his views and opinions?

Completely accurate. Cut the non-medical crap first. Then create tort reform. Abolish the VAMC and fire everyone associated there. Give vets 100% medicare coverage.
From our standpoint: do not cover BZD, do not cover more than 90meq, make addiction care free and have docs hired work for govt and only allowed to Rx bupe with weekly CBT from LCSW/clinpsych.
Stop MBBs, entirely. RF only. 1 and done. If does not work, do not get another shot.

 

[nvrsumr]

Don’t forget vertebroplasty on the list of things that don’t work(mild sarcasm)

 

[SSdoc33]

Completely accurate. Cut the non-medical crap first. Then create tort reform. Abolish the VAMC and fire everyone associated there. Give vets 100% medicare coverage.
From our standpoint: do not cover BZD, do not cover more than 90meq, make addiction care free and have docs hired work for govt and only allowed to Rx bupe with weekly CBT from LCSW/clinpsych.
Stop MBBs, entirely. RF only. 1 and done. If does not work, do not get another shot.

love every single point.

none of it will happen.

 

[hyperalgesia]

I agree with most of this except I'm still not sure about putting vets on Medicare. Medicare is falling apart. MACRA is throwing the kitchen sink at it hopelessly.

Vets are a special case of healthcare where they (at least some) were injured "on the job". The VA guarantees their care in a way that Medicare can't. Trump tried to privatize it but was met with a wall of resistance from all the vet support groups. Right now vets have the option of VA care, free care from Triwest Choice (a private insurer), and some have Medicare as well.

By the way, if you don't accept Triwest currently, you should consider it. The veteran calls Triwest and says, "I want to see Dr. Lobel/SSdoc33". Triwest then faxes you an AUTH for something like "6 visits and injections". You might have to send them your notes to get paid. But still, it's not bad once you get the hang of it from what I understand. Medicare rates.

I do think there could be MAJOR VA reform. Maybe govt agencies should employ "term limits" for all of their employees? So, just a place you go and serve the public and then you're done.

I was actually thinking we could expand basic VA benefits to everyone in the population and then give private insurance to veterans as their special benefit. But I really think, if you're gonna take either/any of these models and expand it, you have to fix it first and demonstrate it is sustainable and provides a superior value.

 

[geauxg8rs]

Completely accurate. Cut the non-medical crap first. Then create tort reform. Abolish the VAMC and fire everyone associated there. Give vets 100% medicare coverage.
From our standpoint: do not cover BZD, do not cover more than 90meq, make addiction care free and have docs hired work for govt and only allowed to Rx bupe with weekly CBT from LCSW/clinpsych.
Stop MBBs, entirely. RF only. 1 and done. If does not work, do not get another shot.

My only criticism is that i have re trialed MBB/Rfa after a local colleague has failed and gotten good results. Same with a recent Tfesi. I had to beg the medical director to let me retry same level that a colleague failed on. Patient had profound relief.

I agree though in principle, if I fail once, I don’t do the same thing. But just because someone else failed, shouldn’t preclude
Me from trying.

 

[lobelsteve]

My only criticism is that i have re trialed MBB/Rfa after a local colleague has failed and gotten good results. Same with a recent Tfesi. I had to beg the medical director to let me retry same level that a colleague failed on. Patient had profound relief.

I agree though in principle, if I fail once, I don’t do the same thing. But just because someone else failed, shouldn’t preclude
Me from trying.

It shouldn't, but maybe 8 mo later.

 

[Disciple]

Looking at the big picture, the population health thinking on this is that if nothing “works” for chronic pain, might as well go for decreased costs, patient satisfaction and harm reduction.